11-06-2006, 11:24 PM
A 78-year-old male presents with worsening malaise
and fatigue over the past 5 months. He also has an en-
larged spleen. His CBC shows a hemoglobin concentration
of 10.6 g/dL, hematocrit of 29.8%, MCV of 92 fL/red cell,
platelet count of 95,000/#L, and WBC count of 4900//xuL.
The WBC differential count shows 67 segmented neutro-
phils, 4 bands, 2 metamyelocytes, 22 lymphocytes, 5 mono-
cytes, and 3 nucleated RBCs per 100 WBCs. The periph-
eral blood smear shows occasional tear-drop cells. An
examination of bone marrow biopsy and smear is most
likely to show
A Marrow packed with myeloblasts
B Marrow fibrosis with greatly reduced hematopoietic
islands
C Replacement of marrow by fat
D Presence of numerous megaloblasts
E Marked normoblastic erythroid hyperplasia
and fatigue over the past 5 months. He also has an en-
larged spleen. His CBC shows a hemoglobin concentration
of 10.6 g/dL, hematocrit of 29.8%, MCV of 92 fL/red cell,
platelet count of 95,000/#L, and WBC count of 4900//xuL.
The WBC differential count shows 67 segmented neutro-
phils, 4 bands, 2 metamyelocytes, 22 lymphocytes, 5 mono-
cytes, and 3 nucleated RBCs per 100 WBCs. The periph-
eral blood smear shows occasional tear-drop cells. An
examination of bone marrow biopsy and smear is most
likely to show
A Marrow packed with myeloblasts
B Marrow fibrosis with greatly reduced hematopoietic
islands
C Replacement of marrow by fat
D Presence of numerous megaloblasts
E Marked normoblastic erythroid hyperplasia